treatment interruptions

May 27, 2003

DR.,
Do you have much experience in your practice in the ralm of STIs? Do you plan on using them on some of your patients once better guidlines have been determined for this activity? Also, which patients are best suited for STIs in terms of when they started treatment in relation to when they were infected? (Early treatment=Better suited for STI)? thank you very much

Response from Dr. Boyle

I am not a huge fan of STIs, since I don't think the data shows that they work, but some of my patients who started therapy when their CD4 counts were relatively high have "taken a break" from their medications for periods of time. Generally, this is only safe in patients who never had a terribly low CD4 count (i.e., they were never <200) since patients can quickly return to their low point when medications are discontinued and may as a result be at risk for new AIDS-related conditions. There are some studies going on with STIs, including 2 being done here at Cornell - one that uses ALVAC (the canary pox vaccine) and IL-2 and another that is an ACTG observational study of patients who stop therapy (not really an STI), and if you are interested in an STI you should probably enroll in a study so that you are monitored carefully and, if your interested, use some medications that may enhance your chance for a successful STI. If you're in the NYC area you can call (212)-746-4435 if you are interested in the canary pox/IL-2 trial or (212)-746-4393 if you are interested in participating in the ACTG observational cohort.

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